Vance Dylan G, Allen David Z, Leming Amy B, Cox Madisyn, Fogg Sonya E, Siddiqui Sameer H, Wilson Hallie R, Tritter Andrew G
Department of Otolaryngology - Head and Neck Surgery, UT Health Houston - McGovern Medical School, Houston, Texas, USA.
McGovern Medical School, University of Texas Health Science Center, Houston, Texas, USA.
Laryngoscope. 2025 Apr;135(4):1236-1247. doi: 10.1002/lary.31867. Epub 2024 Nov 6.
Type 1 Thyroplasty is a well-established procedure used for medializing an immobile vocal fold. Silastic and Gore-Tex are the two most common materials used to accomplish this, but comparative data on their relative efficacy are scarce. We sought to compare outcomes between Silastic and Gore-Tex implants via systematic review and meta-analysis for unilateral vocal fold immobility.
We collected available data from PubMed, Embase, and Web of Science on demographics, maximum phonation time (MPT), voice handicap index (VHI-10/30) score, and any other relevant metrics encountered before comparatively evaluating differences in outcomes.
The search yielded 1,534 records with 55 manuscripts ultimately included. There were 41 unique studies that utilized Silastic for a total of 1038 patients. There were 13 unique studies that utilized Gore-Tex for a total of 245 patients. The pooled mean increase in MPT for Silastic patients was 7.8 s (+1.3 SMD) compared with 5.7 s for Gore-Tex (+1.6 SMD). There was significant publication bias present in both analyses. The pooled mean change in VHI-30 with Silastic was -45.4 (62.2%, -2.09 SMD) compared with -51.6 (73.5%, -1.1 SMD) with Gore-Tex. The pooled mean change in VHI-10 with Silastic was -15.6 (54%, -0.46 SMD) compared with -11.6 (43%, -0.86 SMD) with Gore-Tex. There was no significant publication bias present in VHI outcomes.
Silicone and Gore-Tex implants provide adequate and comparable results in TT1. The data supporting this conclusion are limited by follow-up, diversity in outcomes, limited data availability, and publication bias. Future research should be dedicated to comparing implants in a well-randomized environment. Laryngoscope, 135:1236-1247, 2025.
